Making Sure No One Is Left Behind When it Comes to Nutrition

Nutrition features prominently in the Sustainable Development Goals, but Dr. Jessica Fanzo, one of the experts behind the 2017 Global Nutrition Report, says more work needs to be done to integrate efforts to address malnutrition into other sectors.

A farmer in Bhubaneswar, India, harvests crops. STR/NurPhoto

A LEADING VOICE in the nutrition community, Dr. Jessica Fanzo wants to see a more nutrition-focused development agenda, including more research on nutrition by climate scientists.

Fanzo, an associate professor at Johns Hopkins University, who co-chaired the production of the 2017 Global Nutrition Report, said the Sustainable Development Goals (SDGs) offer a framework for integrating nutrition more systematically within the development agenda, but it’s still an uphill battle.

She gave Malnutrition Deeply her thoughts on the issue.

Malnutrition Deeply: The 2017 Global Nutrition Report looks at how to achieve all of the SDGs and not just SDG 2, which is focused on reaching zero hunger and improved nutrition. Why did you take this approach?

Jessica Fanzo: Using the SDGs as a framework, some countries have been prioritizing specific goals. Some are looking at all 17 goals. We felt that most countries are using the SDGs as a transformative platform to do development strategies for their countries so we really wanted to put nutrition in the framing of the SDGs.

Using an approach where we cluster how different SDGs work together and how they then impact nutrition and nutrition impacts those clustered SDGs, we wanted to show the importance at a deeper level. We will hopefully use this mapping in future reports and use it for how we look at the interactions between different sectors.

We’ll track SDG 2 but look closely at these interactions moving forward. A criticism of the Millennium Development Goals (MDGs) was that it left people behind – the most marginalized and the most vulnerable. So we thought about how we should ensure that the SDG agenda does not leave those behind.

Malnutrition Deeply: How have other disciplines reacted to this approach?

Fanzo: Every discipline does this – they say a particular sector is important to achieve all the SDGs. We have seen this with gender and sanitation as well. We are being ambitious with [this] approach, but if the development community sees nutrition sitting in SDG 2, that in itself is an accomplishment.

An integrated approach is necessary. Focusing on all of the different complicated factors that go into all the issues around malnutrition is important. Getting nutrition on the agenda is important. We still struggle with getting nutrition its rightful place, even within SDG 2. In some countries, SDG 2 is still about producing more rice. We need to be better at clearly communicating with policymakers about what it would take to improve nutrition in their country.

Malnutrition Deeply: Does the community of researchers on climate change need to make a case for nutrition?

Fanzo: I think the SDGs are about climate and sustainability around systems. Climate, biodiversity, resilience is riddled throughout the SDGs. It is a win-win. If we can address climate change, you can address nutrition and hunger as well. The scientists working on climate change are modeling on food security of big staple crops – looking more at productivity and yields of major staple crops around the world.

The modeling needs to expand into the nutritional quality of crops as well but also modeling across the food system. We need to not just look at production. How is it going to change the transport of perishable goods, how is it going to change food safety issues, how is it going to impact food waste? The climate scientists are currently looking at a very limited piece of the food system, and of that, it’s mainly on the yield side. I think there needs to be more science into how climate affects nutrition.

Malnutrition Deeply: What are the challenges of multisectoral approaches to reducing malnutrition?

Fanzo: When we say multisectoral coordination what does that mean? Unpacking what works is difficult when you are taking a multisectoral approach to interventions. Getting other sectors to do research that includes nutrition is also complicated. When you start getting into measuring growth and micronutrients, you need expertise and funding so a lot of people decide not to do that. You need that evidence base to influence policymakers. We have a lot of work to do in how multisectoral approaches work for nutrition.

On the other hand, we know that interventions across single sectors have worked in agriculture, social protection and in [water, sanitation, and hygiene], for example. We have to convince policymakers to continue to encourage this.

The idea of different ministries working together works differently in different countries at various levels. In Nepal, for example, it works at the central level but not so well at the subnational level. There needs to be a lot more work on how do you operationalize central multisectoral plans at the district level and get local governments to work together. But do we even need this? I always ask the question. If every sector did its job, we wouldn’t need multisectoral approaches. This is because budgets are very sectoral – governments don’t fund multisectoral approaches, and there is little knowledge or training.

Malnutrition Deeply: What are you most looking forward to in 2018?

Fanzo: There’s a lot of interesting research being done on diagnostics for nutrients. Biofortification is very promising, and more work needs to be done in the field. I’d like to see more crops being biofortified – it might not be “the” answer for agriculture and nutrition, but it has potential. There are also some innovative policy approaches – the soda tax is a great idea. We need a lot more of that kind of policy innovation happening.

There’s a lot of small examples of what’s working. I’ve been working in Afghanistan, Timor-Leste and Nepal on SDG 2 strategies and countries are very optimistic about the global goal-setting agenda, which is interesting. A lot of lower income countries that are coming out of conflict are going to invest a lot. Superpower countries might not do that, but it’s exciting to see these smaller countries take charge.